Taeusch H W, Keough K M
University of California-San Francisco, USA.
Pediatr Pathol Mol Med. 2001 Nov-Dec;20(6):519-36.
Inactivation of pulmonary surfactant may be important in acute lung injury and acute respiratory distress syndrome. Treatment of surfactant dysfunction by instilling exogenous surfactants may improve gas exchange and pulmonary mechanics. Surfactants used for treatment vary in their attributes and effects, so when various surfactants are considered for therapy, resistance to inactivation is an important consideration. Animal models of acute lung injury exist in which the relative merits of surfactants can be compared. We hypothesize that the surfactants most resistant to inactivation in vitro will be the ones that are most effective in treatment of animal models of acute lung injury. Surfactants with higher concentrations of surfactant proteins specificallly A, B, and C) are more resistant to inactivation. Nonionic polymers mimic surfactant proteins in preventing surfactant inactivation under some conditions. Adding nonionic polymers to surfactant containing minimal amounts of SP-B and SP-C markedly improves lung function of animals with lung injury. Making surfactants more "inactivation-proof" may improve surfactant therapy of acute lung injuries.
肺表面活性物质的失活在急性肺损伤和急性呼吸窘迫综合征中可能具有重要意义。通过滴注外源性表面活性物质来治疗表面活性物质功能障碍可能会改善气体交换和肺力学。用于治疗的表面活性物质在其特性和效果方面存在差异，因此在考虑使用各种表面活性物质进行治疗时，对失活的抵抗力是一个重要的考虑因素。存在急性肺损伤的动物模型，可在其中比较表面活性物质的相对优点。我们假设，在体外对失活最具抵抗力的表面活性物质将是治疗急性肺损伤动物模型最有效的物质。含有较高浓度表面活性蛋白（特别是A、B和C）的表面活性物质对失活更具抵抗力。在某些条件下，非离子聚合物在防止表面活性物质失活方面可模拟表面活性蛋白。向含有极少量SP - B和SP - C的表面活性物质中添加非离子聚合物可显著改善肺损伤动物的肺功能。使表面活性物质更具“抗失活性”可能会改善急性肺损伤的表面活性物质治疗。
